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INSPONSIBLE WORK: Tor Magne Johnsen from the Association of General Practitioners participates in the negotiations. He believes that the medical crisis in the districts will not be resolved if nothing happens with the workload. Photo: Therese Alice Sanne
If the mediation parties do not reach an agreement before midnight, doctors may go on strike across the country in the coming weeks.
Mediation between KS and the Norwegian Medical Association began on Wednesday.
In September, the Academicians broke off negotiations with the municipal sector due to disagreements that mainly concern the emergency room scheme. The Norwegian Medical Association believes that the workload of doctors in the emergency department is too great and that this affects both the GP scheme and the emergency department.
Therefore, they will have restrictions on the amount of work that can be imposed on them in the emergency room.
The mediation period expires at 00:00 on Wednesday, and if an agreement is not reached, the doctors in all the country’s municipalities may go on strike in the coming weeks.
Nils Kristian Klev, leader of the Association of General Practitioners, says they are nowhere close to reaching an agreement before mediation. He says KS has been unwilling to go into concrete solutions that can provide physicians with protection against excessively high workload.
– There is a great danger of conflict unless an agreement is reached in mediation, he says.
Tor Magne Johnsen works as a GP and has also participated in the negotiation. He believes that doctors for several years have been imposed an unjustifiable workload and have worked to achieve change.
– For some 40 years, doctors have been exempt from the working time provisions of the Work Environment Act. We simply can no longer accept an unlimited exception. This affects both patients and doctors. From the 2018 GP survey, we know, among other things, that more than 60 percent of doctors say that their work is harmful to their health. We need a framework that guarantees work time that is livable, for each individual doctor. These are dual-job doctors. If we don’t take care of our district physicians and provide them with a more secure framework for working hours, we will never solve the hiring crisis in the GP scheme, says Johnsen.
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Work an average of 70 hours a week
Johnsen points to time-use surveys from the Norwegian Directorate of Health that show that district doctors who go to the ER work an average of 70 hours per week, and that one in 10 doctors in smaller municipalities works more 100 hours in the emergency room per week.
– This workload affects the recruitment for both the emergency room and the GP scheme and therefore the emergency room staffing. In rural areas, this is the main cause of the hiring crisis. At the same time, we see municipalities that have taken responsibility hiring enough doctors and giving their doctors lively work schedules, recruiting new doctors for their positions, and managing to keep their GPs, Johnsen says.
– The pandemic in which we find ourselves shows how crucial good medical preparation is in municipalities. More than 90 percent of the patients with covid-related requests were evaluated and completed in the municipalities.
The union requires doctors to give their consent if they must work more than seven hours of emergency care per week, which corresponds to 28 hours of emergency care.
– Doctors should have the right to set an upper limit on their workload, a limit which, after all, is well above normal working hours. In addition to the fact that they work an average of 50 hours as GPs, today they can be required to have an unlimited emergency room. In reality, it is a paradox that we have to go on strike to be allowed to work less than 60 hours, says Klev of the Association of General Practitioners.
Marit Hermansen, president of the Norwegian Medical Association, says that the Norwegian Medical Association is prepared to do everything possible to reach a solution with KS in the ongoing mediation.
– But, as in all other settlements, a strike is a possible outcome if the parties do not reach an agreement.
KS: requires a long-term solution
Tor Arne Gangsø, director of working life at KS, emphasizes to VG that he cannot comment on an ongoing mediation. In an article in Dagens Medisin, he wrote in September that KS has long voiced concerns about the GP scheme, reiterating that the ER is a central part of the problem.
– The problem of the emergency room requires a long-term solution for both doctors and residents and municipalities. We do not solve this through a collective agreement, he wrote, and further:
– We want a long-term solution that makes it attractive for young doctors to invest in the general practitioner service in the future; a system that assures residents of all municipalities 24-hour emergency care and that provides us with a sustainable GP scheme for a long time.
